Impaired Health Care Providers

From the TV show "House"

Alcohol and Drug Dependence does not discriminate.  Contrary to popular belief, addiction among health care professionals is as prevalent as the general population, possibly even higher in some specialties (i.e. anesthesiologists).  Several popular TV shows such as “ER” and “House” have highlighted alcohol and drug problems among physicians, nurses, residents, and medical students.

One of the hallmark defense mechanisms of substance dependence, DENIAL (Don’t Even (k)now I Am Lying), makes it difficult for those afflicted to get help.  Denial may be particularly pronounced in health care providers because they may see themselves as “all-knowing” health care providers who don’t need help.  They may also have a quite reasonable fear of losing their license to practice their profession.

So, what do you do when you notice that a colleague or another health care provider such as a physician or nurse may have a problem with alcohol or drugs?

  1. It is paramount to consider the pros and cons of confronting and not confronting the individual directly.  For example, without the proper preparation and support, a well-meaning attempt to address a potential problem directly with the individual may not only fall flat but may elicit hostility or push the person even further from getting help.  Choosing to not confront the individual may directly or indirectly result in patient harm.
  2. Seek support and guidance from a colleague versed in alcohol and drug treatment.  They may be able to provide the insight, language, and knowledge to help approach the individual directly.
  3. Every state has a program for impaired health professionals.  The Federation of State Physician Health Programs is an excellent resource to report a problem anonymously or to seek free expert consultation about how to handle a specific situation.

Photo by karawynn

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One Response to “Impaired Health Care Providers”

  1. Dr. Robert Fettgather   January 31, 2011 at 6:41 pm

    Dr. Barnett’s article addressed the problem of the addicted medical professional succinctly and with resources. However, as Psychologist who has worked in the field of Chemical Dependency for the last 25 years, I believe both the problems and the solutions are profound and complex than ever. Addictive disorders are more broadly defined today (including many compulsive behaviors-spending; sexual activity etc.) and more profoundly linked to neuropsychological-environmenmental causes. An abiding symptom remains- does it interfere with a major life function in a mild, moderate or severe way.

    For health professionals, interference with professional functioning even to a mild degree can affect clinical outcome. My friend and Mentor David Breithaupt, MD has been an outspoken expert on this issue for decades, and the Denial of the addict can be paralleled by the Denial of the institution (his recent book R.I.C.E. speaks powerfully to the problem).

    In a culture more disabled by addiction than ever before, Dr. Barnett and Dr. Breithaupt bring to professional awareness a systemic problem requiring an intervention of systemic solutions.